Health/Disease Strategy

Joan Kennedy's mantra is centered on empowering a multidisciplinary team of providers.

As wellness and prevention color the DM landscape, Jim Prochaska is in line as creator of the Transtheoretical Model of Behavior Change.

As a Medicaid plan, AmeriHealth Mercy needs innovative approaches to treat its unique population.

According to Harold Picken, MD, Blue Cross Blue Shield of Rhode Island will become the first health plan to create a tight transfer between coded physician assessments of Medicare members and disease management.

Gordon K. Norman, MD, is helping shape the dialogue surrounding the merging of DM with the medical home concept.

As co-founder and CEO of Health Dialog, Bennett has seen the company grow.

Emad Rizk, MD, has devoted his energies to developing a disease management model that extends beyond telephonic communications to an on-the-ground, comprehensive model.

WellPoint's Comprehensive Health Solutions Business Unit provides an industry best practice in population-based healthcare management through its 360-degree Health programs.

D.W. Edington's research focuses on the precursors of disease and the relationships between healthy lifestyles, vitality, and quality of life.

David W. Plocher, MD, has designed an in-house DM program, launching later this year.

David B. Nash, MD, is on the front lines of DM with his academic institution's sponsorship of the Population Health Colloquium, a leading forum in chronic care and DM.

Christobel Selecky has spent 27 years in the healthcare industry, leading LifeMasters since 1996.

Lowe's is the first mega-employer to adopt event-rate measurement, which is being

Ben Leedle, Jr., is a trailblazer at Healthways, having helped drive revenue from $165 million in 2003 to more than $615 million in 2007.

Ariel Linden, DRPH, has contributed numerous peer-reviewed published articles, reflecting his knowledge in evaluating program effectiveness.

Barry Lachman, MD, is probably most noted for his landmark DM programs for children with asthma and the prevention of respiratory synctial virus infection in preterm infants.

There's been a continued interest in how medication adherence can improve both health outcomes and patient safety.

Disease registries are gaining in popularity as electronic tools designed to give physicians clinical support to deliver appropriate care.

How is it that well-informed people can look at the same data and come up with dramatically different conclusions and action implications? It turns on whether the analysis is done by biostatisticians looking at utilization data in an academically rigorous way, or by actuaries and benefits consultants looking at overall financial trends in a pre-post manner.

The practice of shared decision making (SDM)-the collaboration between patients and caregivers to arrive at an informed, value-based healthcare decision when treatment options have features that patients value differently-is gaining recognition among health plans as a key function of a patient-centric model of care.

Health and productivity management (HPM), disease management (DM), and wellness programs continue to gain traction in the corporate marketplace. As employers and vendors address gaps, these programs will become fundamental in employer efforts to contain health benefit costs, better manage benefit use, and achieve transparency across employee data.

According to the 2007 Milken Institute Report, "An Unhealthy America: The Economic Burden of Chronic Disease," prevention, early detection and chronic condition management could save the nation $1 trillion annually by 2023. But in the mind of U.S. Preventive Medicine Founder (USPM), Chairman, CEO and Director Christopher Fey, there is something even more important that could be saved: lives.

Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.

Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.

Although prevention has become a key element in traditional disease management programs-trying to prevent or mitigate a chronic disease before it exacerbates-that may not be sufficient when a patient has a late-stage or end-of-life condition. There is a new emphasis on caring for older adults with multiple comorbidities. Almost 80% of people 65 and older report having a chronic illness, according to the Robert Wood Johnson Foundation.

HIPAA prohibits group plans from charging higher premiums to individuals due to health status, medical history, genetic information, claims experience, receipt of care or evidence of disability. The Department of Labor's Employee Benefits Security Administration recently issued guidelines that closed off a loophole that might have allowed employers to charge less healthy workers higher deductibles.

Medicare Advantage plans escaped threatened payment cuts last year, but the issue is at the top of the health policy legislative agenda for the coming months. Legislation enacted in late December postponed a scheduled reduction in Medicare payments to physicians-but only for six months. Congress paid for that short delay plus an extension of the State Children's Health Insurance Program (SCHIP) without cutting MA rates or raising taxes.

National reports-The movement toward the patient-centered medical-home model has gained rapid momentum over the past year, marked by several watershed events.

HIPAA prohibits group plans from charging higher premiums to individuals due to health status, medical history, genetic information, claims experience, receipt of care or evidence of disability. The Department of Labor's Employee Benefits Security Administration recently issued guidelines that closed off a loophole that might have allowed employers to charge less healthy workers higher deductibles.

The real potential for the application of incentives, rewards and recognition programs is in the broader context of overall employee health, as well as benefit programs and retirement planning initiatives driven by consumer directed healthcare strategies.